Mpox's Next Target: Guess Which Country Was Hit First Outside Africa

Mpox’s Global Resurgence: Europe’s First Case of Clade I and the Emerging Threat Beyond Africa

Overview
The recent identification of Clade I mpox in Sweden marks the first case of this strain outside Africa, signaling a concerning development in the global fight against the disease. As Europe grapples with this new challenge, it is essential to understand the implications, preparedness strategies, and potential global spread of this more severe strain of mpox.

The Emergence of Clade I Mpox in Sweden
Sweden’s confirmation of its first Clade I mpox case has drawn significant attention, especially following the World Health Organization’s (WHO) declaration of a Public Health Emergency of International Concern (PHEIC). The patient, who contracted the infection while traveling in an affected region of Africa, has been isolated and treated. This case highlights the increasing risk of mpox spreading beyond Africa due to international travel.

Differentiating Clade I from Clade II
Clade I mpox, dominant in the Democratic Republic of Congo (DRC), differs notably from Clade II, which was responsible for the 2022 global outbreak. While Clade II primarily spread through sexual contact, particularly among men who have sex with men, Clade I has broader transmission routes, including household contact and exposure to infected animals. This strain also poses a higher risk of severe disease, especially in young children, pregnant individuals, and those with compromised immune systems.

The Growing Crisis in Africa
Mpox has been an escalating crisis in Africa, particularly in the DRC, where Clade I has caused over 15,600 infections and 537 deaths. The recent outbreaks in countries like Burundi, Kenya, Rwanda, and Uganda, which had not previously reported mpox, have further exacerbated the situation. The Africa Centres for Disease Control and Prevention (Africa CDC) has declared a continental public health emergency, acknowledging that the true scale of the outbreak may be underreported.

Global Response and Preparedness
In response to the growing threat, the European Center for Disease Prevention and Control (ECDC) has raised the risk level of mpox transmission within the European Union. European countries, including Sweden, Italy, and Britain, have issued public health warnings and increased preparedness. The European Union, in collaboration with Africa CDC, is also stepping up efforts to contain the spread in Africa by donating vaccines to the most affected regions.

Vaccination and Prevention Efforts
Two vaccines, including Jynneos, have been approved for use against mpox. These vaccines can be administered as both preventatives and post-exposure prophylaxis. However, vaccine supplies remain insufficient in many African regions, posing a significant challenge to controlling the outbreak. The recent acquisition of over 215,000 doses by Africa CDC, with support from the European Commission, is a step forward, but more efforts are needed to ensure broader coverage.

Implications for Europe and Beyond
The emergence of Clade I mpox in Europe is a stark reminder that no region is immune to the global spread of infectious diseases. As health authorities in Sweden and across Europe monitor the situation closely, there is a pressing need for increased awareness, rapid response, and international cooperation to prevent a wider outbreak.

Conclusion
The detection of Clade I mpox in Sweden serves as a critical warning that the global community must remain vigilant. As the situation evolves, ongoing research, public health measures, and international collaboration will be crucial in mitigating the impact of this emerging threat.